Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia.

Abstract

Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly either presenting as a congenital heart disease or occurring secondary to cardiac surgical interventions. A 19-year-old male patient presented with chest pain and shortness of breath. On auscultation, a grade 4/6 early diastolic murmur was heard over the left lower sternal border and Erb's area with a thrill. Crepitating rales were heard over bilateral basal lung fields. The electrocardiogram showed right bundle branch block and ST depression. Troponin and CK-MB levels were increased. Shortly after admission, he developed ventricular fibrillation and was defibrillated three times. After restoration of hemodynamic stabilization, transthoracic echocardiography was performed, which showed grade 4 aortic regurgitation, patent foramen ovale, and an aneurysm of the sinus of Valsalva arising from the right coronary sinus, with rupture into the right ventricle. The patient underwent surgery under cardiopulmonary bypass, for repair of the ruptured SVA and patent foramen ovale and aortic valve replacement. He was discharged on the fifth postoperative day following an uneventful operation and postoperative course.

• Authors: Abdulkadir Yıldız, Aytun Canga, Nihat Sen
• Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir (Turk Kardiyol Dern Ars) Vol. 38 Issue 6 Pg. 419-21 (Sep 2010) ISSN: 1016-5169 [Print] Turkey
• PMID: 21200122 (Publication Type: Case Reports, Journal Article)

Topics

• Aortic Rupture (diagnosis, surgery)
• Aortic Valve Insufficiency (diagnosis, surgery)
• Humans
• Male
• Myocardial Ischemia (diagnosis, surgery)
• Sinus of Valsalva (pathology, surgery)
• Treatment Outcome
• Young Adult